I don't expect you to think insurance is cool like I do, but you will know more at the end than you did at the beginning.
Premium: the amount that you pay every month. This number is affected by many things: health rating, deductable and coinsurance. Premium is directly related to deductable and coinsurance. It is all about risk. More risk for the insurance company = more premium for you. If you take on more risk (higher deductable), your premium will decrease.
Deductable: the amount of money that you are responsible for (to pay out of your pocket) before the insurance company takes full responsibility for any remaining medical bills. Deductables are calculated on an annual basis, and reset at the beginning of each year. Deductables currently range from $500 to $12500 per year. Look for the insurance companies to offer higher deductables in response to the Affordable Care Act (Obamacare).
Coinsurance: an option that can be selected in order to help lower monthly premiums. These are dollars that you would owe in addition to the deductable. Once the deductable is paid, the remaining medical bills would be split between you and the insurance company. Every company offers different splitting options: 50/50, 60/40, 70/30, 80/20. Under these scenarios, the insurance company would cover the larger portion of the bill, and you would be on the hook for the rest. For example: a $20000 bill (amount remaining after your deductable has been satisfied) with an 80/20 plan... the ins company would pay $16k, and you would owe $4k. Almost all coinsurances have a coinsurance max. This places a cap on the amount that you would owe in any calender year. ie: coinsurance max of $5000. You would pay your deductable, then up to $5000 for your coinsurance, finally, the insurance company would cover the remaining medical bills for the rest of the year.
head spinning yet?
Copay: a fixed amount for services rendered. ie: doctor copay ($35), specialist ($50), ER copay ($100), you get the idea. Every insurance company utilizes copays differently. This is a major component for some consumers to have in there health plan.
Max out of Pocket (MOOP): the most that you will have to pay in any calender year. The deductable plus any coinsurance = MOOP.
In Network: insurance companies negotiate rates (with doctors and hospitals) for all services that they are willing to cover. All docs and hosptials that accept the negotiated rates are "in network". Typically, the insurance company with the most clients will have the largest network, and the lowest negotiated rates. You will pay the negotiated rate for any service that doesn't have a copay, and that is covered by the insurance company.
Out of Network: doctors are not required to be "in network" with any insurance company. When you utilize a doctor, or service that is not in your insurance company's network, the costs are much higher. The deductable limits do not apply to out of network services. Every company has different rules regarding out of network costs, and understanding them is a must. The bottom line is that being a client of a company with a large network is a great benefit.
I have just scratched the surface of the ins and outs of the health insurance game, but I hope that you are smarter than you were when you started.
Opinions, thoughts and comments are always appreciated.
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people that have I have recently learned something from: +Enoch Simmons , +ethanpajak@yahoo.com 
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